I am aware of the DCCT recommendation ("closest to normal blood glucose with the minimum number of lows"), but what is the concern regarding lows here? What are the effects of severe reactions in the short term? My seven year old daughter has lows somewhat frequently, one or two times a day in the mid 40s mg/dl [2.4 to 2.6 mmol/L]), but feels fine when low. We treat these lows anyway, but are afraid that, in the long term, they can cause some harm. What are the long term effects of lows? Can she develop hypoglycemia unawareness? If she does, can it be reverted by "training" the body again, maybe keeping a higher blood glucose for some time?

Answer:

Surely, hypoglycemia could be as harmful as hyperglycemia; in fact, some studies have demonstrated a link between frequent low blood sugar levels and ocular complications. As well, frequent readings in the mid 40s mg/dl [2.4 to 2.6 mmol/L] are not good also if your daughter feels well during these episodes. The possibility that she has some kind of hypoglycemia unawareness could be taken into consideration. I don't know if hypoglycemia unawareness could be resolved (I don't think so), but for sure I will discuss with your diabetes team a new insulin scheme in order to avoid so many hypoglycemic reactions.

Last Updated: Tuesday April 06, 2010 15:09:58
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